Early diagnostic value of hypersensitive C-reactive protein and D-dimer levels evaluated by the ROC curve in patients with acute aortic dissection

Abstract

Objective To investigate the early diagnostic value of D-dimer and hypersensitive C-reactive protein (hs-CRP) level in acute aortic dissection (AAD). Methods The 382 patients with chest and back pain enrolled from January 2010 to December 2012 were divided into AAD group and control group by computerized tomographic angiogmphy (CTA). D-dimer and hs-CRP levels were compared between two groups.The positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity of D-dimer and hs-CRP testing were analyzed by means of ROC curve. Results The D-dimer and hs-CRP levels in AAD were significantly higher than those in controls [(9.40±18.79) mg/L vs. (0.31±0.28) mg/L, t=3.868, P<0.01; (31.88±40.05)mg/L vs. (5.98±16.16)mg/L, t=4.237, P<0.01]. ROC curve analysis showed that D-dimer (0.56 mg/L) and hs-CRP(5.94 mg/L) were predictive in the early diagnosis of AAD with PPV of 85.7% and 75.9%, NPV of 98.3% and 69.3%, sensitivity of 98.1% and 61.9%, specificity of 75.2% and 71.8%. Conclusions D-dimer and hs-CRP may be the effective and important biomarkers in early diagnosis of AAD. Key words: Acute aortic dissection; Hypersensitive C-reactive protein; D-dimer; Receiver operating characteristic; Early diagnosis